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