| NPI | 1104565563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11032432) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 20642) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 76869) | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2024-12-03 |