| NPI | 1760762140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 221700000X Art Therapist (Licence: NY 002001) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2016-07-15 |