| NPI | 1033606165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA NCO-000003) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 11296) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 72665) | |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2025-09-15 |