| NPI | 1104371152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2337491) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 11633-MH-CC) |
| 101YM0800X Counselor, Mental Health | |
| 163W00000X Registered Nurse (Licence: MA RN2337491) | |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2021-07-29 |