| NPI | 1104980218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 318737) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: AZ 10122) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2025-01-17 |