| NPI | 1700050218 |
|---|---|
| Former Name | AMISHA AUGUSTINE SAMUEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 001080-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2014-05-13 |