| NPI | 1013960707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2379145) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 363LP0808X) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G136589) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT APRN-180328) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-09-21 |