| NPI | 1548912603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 221700000X Art Therapist (Licence: NY P111965) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 34448) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |