| NPI | 1093364317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11003837) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 11003837) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2022-02-25 |