| NPI | 1710398748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 010636) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 100532-01) |
| 171M00000X Case Manager/Care Coordinator | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2021-03-24 |