| NPI | 1154406411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 22112) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 1272) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-12-10 |