She has been in private practice for fifteen years, providing services to people faced with mental and physical health challenges: chronic and terminal illnesses including end of life issues as well as individuals desiring to change lifestyle practices to optimize their overall health status and quality of life. She has worked closely with physicians and medical and mental health providers in primary and specialized care environments: internal medicine, family medicine, cardiology, nephrology, and surgery. In so doing, she has conducted health and behavioral assessments and interventions to patients and their families, to potential candidates for bariatric surgery over the course of treatment [pre-surgery, weight loss and maintenance stages], to nephrology patients suffering from and nearing end stage renal disease, many of whom require life-sustaining treatments: dialysis or transplantation.