| NPI | 1083468912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP029502) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA SP029502) |
| 101YM0800X Counselor, Mental Health (Licence: PA SP029502) | |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2024-06-03 |