| NPI | 1902451115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407168) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105537) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2025-11-11 |