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 |