| NPI | 1275790792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000453) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 000453) |
| 103TR0400X Psychologist, Rehabilitation (Licence: NY CRC #00006721) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |