| NPI | 1659667806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 695419) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2015-12-14 |