| NPI | 1770856502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY 004833) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 22841) |
| 101YM0800X Counselor Mental Health (Licence: NY 004833) | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-09-23 |