NPI | 1053639088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R883581) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 1360) |
106H00000X Marriage & Family Therapist (Licence: MS T0434) | |
Enumeration Date | 2010-05-14 |
Last Update Date | 2012-09-19 |