| NPI | 1962851493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402172) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004683) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-07-21 |