NPI | 1811251127 |
---|---|
Former Name | AMY DZIOMBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 005701) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2018-05-23 |