NPI | 1053996272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9556) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5022895) |
Enumeration Date | 2021-03-10 |
Last Update Date | 2025-08-20 |