| NPI | 1013295344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP09644) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 4823) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2017-11-15 |