| NPI | 1134502578 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN3027352) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN3027352) | 
| Enumeration Date | 2015-07-02 | 
| Last Update Date | 2025-02-28 |