| NPI | 1487811816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY R-019119-1) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 692) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 8265) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |