| NPI | 1811191414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401198) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 011974-1) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2022-08-04 |