| NPI | 1700943198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 2224) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001270-1) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |