| NPI | 1932540663 |
|---|---|
| Former Name | JULISSA CAMPOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 006711) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 29180) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2025-09-05 |