| NPI | 1679777114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 078279) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 074319-1) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2017-02-20 |