| NPI | 1003035478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN209888) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 209888) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 209888) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2022-02-18 |