| NPI | 1902227598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 0833391) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 0833391) |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2015-08-04 |