| NPI | 1497146377 |
|---|---|
| Former Name | AMY YANDOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000626) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0099058) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2016-11-30 |