| NPI | 1013891761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: LA 349216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 349216) |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-09-18 |