| NPI | 1952813776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 015079) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 33583) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2024-10-21 |