| NPI | 1093339319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA rn227911) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 163W00000X Registered Nurse (Licence: GA RN227911) | |
| 251S00000X | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2023-07-05 |