NPI | 1720482748 |
---|---|
Former Name | LANDIS CLEARY BLOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 008127) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P9745) |
Enumeration Date | 2014-10-20 |
Last Update Date | 2020-08-11 |