| NPI | 1902217243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 006907-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY P92495) |
| 163W00000X Registered Nurse (Licence: NY 481182) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2016-01-11 |