| NPI | 1407018591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY 002250-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 11051) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NY 11051) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-06-12 |