| NPI | 1215473509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 006001) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 22674) |
| 101YM0800X Counselor Mental Health (Licence: NC 16257) | |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2023-08-21 |