| NPI | 1013883636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407586) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0011004) |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2026-05-09 |