| NPI | 1407227879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 090232) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 31589) |
| 101YP2500X Counselor, Professional (Licence: NY 4937560) | |
| 104100000X Social Worker (Licence: NY 72091813) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2022-02-23 |