| NPI | 1508141789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 082840) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY CASAC-27019) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2017-01-19 |