| NPI | 1780667287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401721) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 396177-1) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2015-02-16 |