| NPI | 1710536594 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403089) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 707649) | 
| Enumeration Date | 2019-09-05 | 
| Last Update Date | 2025-06-10 |