| NPI | 1619284114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004548) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0015638) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2020-04-03 |