| NPI | 1508125279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405711) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2024-07-12 |