| NPI | 1619229507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 087044) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC C007998) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2018-06-18 |