| NPI | 1154859981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 408120) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 271063) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2026-02-27 |