| NPI | 1245612779 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00562000)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 006573)  | 
| Enumeration Date | 2015-06-21 | 
| Last Update Date | 2018-04-01 |