| NPI | 1902213812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401802-1) |
| Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: NY 659227-1) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2015-02-28 |