| NPI | 1649354879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 019040) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 694891-1) |
| 163W00000X Registered Nurse (Licence: MA RN2300483) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 17974) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2018-07-02 |