| NPI | 1235467291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402671) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 082747) |
| 163W00000X Registered Nurse (Licence: NY 667177-1) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2019-07-10 |