| NPI | 1255610911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402410-1) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 019187) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2020-10-15 |