| NPI | 1326349663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 074533-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 074533-1) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2010-11-03 |