| NPI | 1629263769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 085857-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 078911) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 24563) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2018-07-12 |