| NPI | 1720854243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1741366231) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 1741366231) |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-08-15 |