| NPI | 1366927071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 010164) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P11384) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 30884) | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2023-05-09 |