| NPI | 1043290968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024066119) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0015000548) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2024-06-19 |