| NPI | 1134689078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 289319) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1099241) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 72660) | |
| Enumeration Date | 2019-03-25 | 
| Last Update Date | 2025-10-27 |