| NPI | 1023180221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95018953) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95085804) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2022-01-05 |