| NPI | 1083895965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP008361) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA SP008361) |
| 101YM0800X Counselor, Mental Health (Licence: PA SP008361) | |
| 101YP2500X Counselor, Professional (Licence: PA SP008361) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2019-09-24 |