| NPI | 1770125767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 012803) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 012803) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2026-03-17 |