| NPI | 1609110501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 8926) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: NY 006174-1) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2014-09-04 |