| NPI | 1922499581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0015433) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NY P91532) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2022-01-18 |