| NPI | 1174237143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 015040) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407311) |
| 163W00000X Registered Nurse (Licence: CT 196821) | |
| 163W00000X Registered Nurse (Licence: NY 990953) | |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2025-10-08 |