| NPI | 1790255057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 009156) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: NY 00250511) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |