| NPI | 1235213547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F400319) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY RN 222212) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-12 |