| NPI | 1689767592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 10712) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY R049140-1) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-09 |