| NPI | 1114425758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 37222) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 163W00000X Registered Nurse (Licence: TN 274501) | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2025-07-22 |