| NPI | 1285025965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 3819392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 738515) |
| 164W00000X Licensed Practical Nurse (Licence: NY 320771) | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2026-05-20 |