| NPI | 1104456961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.020728) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 115698) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 1681833) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71013331A) | |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2025-06-16 |