| NPI | 1063606614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9211884) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6763) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2020-04-16 |