| NPI | 1235676594 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 13282) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 20825) | 
| 101YP2500X Counselor, Professional (Licence: NY 508264) | |
| Enumeration Date | 2017-01-25 | 
| Last Update Date | 2023-10-05 |