| NPI | 1407363765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 008377) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: NY 00176494) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |