NPI | 1093339319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA rn227911) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
163W00000X Registered Nurse (Licence: GA RN227911) | |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2020-06-02 |
Last Update Date | 2025-03-14 |