| NPI | 1326005836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN148123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 6439) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401997) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-07-21 |