| NPI | 1821368705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4952) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004236-1) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2019-04-25 |