NPI | 1790765097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY PRO199711) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY PRO199711) |
Enumeration Date | 2006-01-20 |
Last Update Date | 2012-09-21 |