| NPI | 1073531927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 001492) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000579) |
| 163W00000X Registered Nurse (Licence: CT R29021) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-10-13 |