| NPI | 1639287162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000129) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH4294) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |