| NPI | 1023440161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G184717) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 314314) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2025-07-15 |