| NPI | 1487272936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY P105914) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY P105914) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |