NPI | 1770810608 |
---|---|
Other Name | JILL MARIE IZYDORCZAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY LMHC-004391) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 20452) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY CASAC-20452) | |
Enumeration Date | 2009-11-13 |
Last Update Date | 2022-03-22 |