| NPI | 1033262449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002227) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 002227) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-10-08 |