| NPI | 1992147920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401640) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 079933) |
| 163W00000X Registered Nurse (Licence: NY 651552) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2015-09-16 |