| NPI | 1124406400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 08461) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: LA RN129729) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2023-01-12 |