| NPI | 1063270783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11031460) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-26-89573) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2026-05-01 |