| NPI | 1114262110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 8831) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ 132181) | |
| Enumeration Date | 2012-12-01 |
| Last Update Date | 2024-08-29 |