NPI | 1366643439 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 0005621) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 12290) |
164W00000X Licensed Practical Nurse (Licence: NY 098015) | |
Enumeration Date | 2007-05-29 |
Last Update Date | 2011-01-05 |