| NPI | 1114119518 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: GA RN185785 CNS/PMH) | 
| Enumeration Date | 2007-08-10 | 
| Last Update Date | 2007-08-10 |