| NPI | 1255704664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 101239) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 02249154) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2018-03-17 |