| NPI | 1710341243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY P96787) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 007957) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2020-11-05 |