| NPI | 1710232798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406728) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 3059521) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-07-09 |