| NPI | 1902123433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 006066) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY P74642) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2016-06-27 |