| NPI | 1013663194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 0998745) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 1662254) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0998745) | |
| Enumeration Date | 2022-02-26 |
| Last Update Date | 2024-12-10 |