| NPI | 1124282470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2290510) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 8236) |
| 163W00000X Registered Nurse (Licence: MA RN2290510) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2020-01-22 |