| NPI | 1013031459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11026858) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 22445) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-06-22 |