NPI | 1073943155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP124211) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5014161) |
164W00000X Licensed Practical Nurse (Licence: TX 788112) | |
Enumeration Date | 2013-11-26 |
Last Update Date | 2021-04-29 |