| NPI | 1780969220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NY 001269) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 24438) |
| 101YM0800X Counselor, Mental Health (Licence: 11-157) | |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2012-08-27 |