| NPI | 1033148028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK ANPLIC#170) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AK LMFTLIC#33) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 170) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2011-12-22 |