| NPI | 1023485208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.006576) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CT 10.121925) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2020-06-23 |