| NPI | 1215205802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 002167) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 002767) |
| 101YS0200X Counselor School | |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2020-06-22 |