| NPI | 1811104128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY R032375) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NY 000614) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |