| NPI | 1104308204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI APRN02139) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 11940) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2024-05-11 |