| NPI | 1609831106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 5134) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R042699-1) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-07-08 |