| NPI | 1619314135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402174) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 606294) |
| 163W00000X Registered Nurse (Licence: NY 606294) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402174) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2024-02-26 |