| NPI | 1154936680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0138322) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9534163) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2025-10-20 |