| NPI | 1356921951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 011473) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 103526-01) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2022-03-07 |