| NPI | 1619095650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY 000395) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 000395) |
| 101YP2500X Counselor, Professional (Licence: NY 000395) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 000395) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2025-09-11 |