NPI | 1114596624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019647) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 95142217) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024183375) | |
Enumeration Date | 2021-06-18 |
Last Update Date | 2023-05-25 |