| NPI | 1376807172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004807) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 250919) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |