| NPI | 1194228270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 0489049) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 674247) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NY 674247) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 674247) | |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2022-11-10 |