| NPI | 1306049085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 075596) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 12859) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2019-09-30 |