| NPI | 1124647789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11006706) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN11006706) |
| 363L00000X Nurse Practitioner (Licence: FL 11006706) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2022-12-13 |