| NPI | 1558352336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 10704) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R052445) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |