| NPI | 1508202342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402992) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 72 088144) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 760350) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2020-08-14 |