| NPI | 1912147885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY CERT #11727) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 002505-1) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2016-02-22 |