| NPI | 1063204469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024194447) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001284498) |
| Enumeration Date | 2025-05-21 |
| Last Update Date | 2025-12-04 |