| NPI | 1679681811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400201) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R039934-1) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2007-10-27 |