| 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 |