| NPI | 1043736523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 237861) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2025-09-12 |