| NPI | 1104481316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405017) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 088946) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 832226) | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2023-06-09 |