| NPI | 1770774879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: NY x005167) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 003651-1) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |