| NPI | 1023160397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 043191-23-08) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NH 213) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2012-09-24 |