| NPI | 1134649031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN207207) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN207207) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN207207) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |