| NPI | 1316035553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 010873) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F400121) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-11-21 |