| NPI | 1134722127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11009979) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009979) | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2024-10-13 |