| NPI | 1487901526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY CRC-0053824) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY CASAC-19821) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |