| NPI | 1043230170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2298750) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 7438) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-07-21 |