| NPI | 1104718568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA NP004962) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: AL 1-187095) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 343916) | |
| 163W00000X Registered Nurse (Licence: AL 1-187095) | |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2026-08-11 |