| NPI | 1073866463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN217151) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2023-01-30 |