| NPI | 1053835652 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 21192)  | 
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: SC 75918r)  | 
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC 75918r)  | |
| Enumeration Date | 2017-07-26 | 
| Last Update Date | 2021-06-15 |