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 |