| NPI | 1023477601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 20757) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 363LF0000X Nurse Practitioner Family (Licence: TN 182482) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TN 182482) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2025-02-20 |