| NPI | 1740512516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 299858-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY p99037) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2017-01-20 |