| NPI | 1053958850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP145794) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 290225) |
| 163W00000X Registered Nurse (Licence: TX 867185) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 46903) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0027883) | |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2022-12-09 |