| NPI | 1740524784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 14687) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 311730) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2025-05-20 |