| NPI | 1134526684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2020007335) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 118062) |
| 163WC1500X Registered Nurse, Community Health (Licence: MA RN2321886) | |
| Enumeration Date | 2014-11-28 |
| Last Update Date | 2020-07-09 |