| NPI | 1235288614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401211) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R056252-1) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2014-05-23 |