| NPI | 1962020743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 012710) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 014015) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2024-06-07 |