| NPI | 1013263862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F406968-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 735418) |
| 164W00000X Licensed Practical Nurse (Licence: NY 310225) | |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2025-05-05 |