| NPI | 1407203797 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 000314-1)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001785-1)  | 
| Enumeration Date | 2016-05-17 | 
| Last Update Date | 2016-05-17 |