| NPI | 1033316179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G135058) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IA 006915) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 10028) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2016-07-27 |