| NPI | 1306990122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R045026) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 045026) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-10-16 |