| NPI | 1710315098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 004097) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 4829) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |