| NPI | 1619046828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 3188) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R055234-1) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |