| NPI | 1407300650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 089925) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 35660) |
| 1041C0700X Social Worker, Clinical (Licence: NY 101232) | |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2025-01-27 |