| NPI | 1083253017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2307795) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2023-06-23 |