| NPI | 1104074210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R873052) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MS C5063) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP09407) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP7757) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 1451) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2023-09-14 |