| NPI | 1629174982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY LCSWR032652) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 1436) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2019-03-13 |