| NPI | 1790043594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 084087) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: NY 00087702) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2022-05-31 |