| NPI | 1104353663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-50666) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2025085756) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018970) | |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2026-05-23 |