| NPI | 1417006818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F40117-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 069855) |
| 163W00000X Registered Nurse (Licence: NY 568571) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-03-10 |