| NPI | 1134364854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401159) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 401159) |
| 282N00000X General Acute Care Hospital (Licence: NY 401159) | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2014-02-28 |