| NPI | 1073949509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002708) |
| Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: CT 002708) |
| 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: NY 7903263) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 7903263) | |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2025-04-30 |