| NPI | 1992996805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NY 18-004550) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 18-004550) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2012-12-07 |