| NPI | 1073865556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 266504) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 266504) |
| 273R00000X Psychiatric Unit (Licence: NY 266504) | |
| 282N00000X General Acute Care Hospital (Licence: NY 266504) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: NY 266504) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2012-10-09 |