| NPI | 1053798199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 295014) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ 29408) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2024-03-21 |