| NPI | 1255102976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405625) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1149539) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ15047800) | |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2025-07-07 |