| NPI | 1063515369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.010527041.189584) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004744) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2017-03-14 |