| NPI | 1679951867 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R249295)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 670220)  | 
| Enumeration Date | 2015-05-08 | 
| Last Update Date | 2025-03-26 |