| NPI | 1023867785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407505) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN259072) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: GA 2025040897) | |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2026-06-11 |