| NPI | 1154953073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 5339496-4405)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201910986RN)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 5339496-8900)  | |
| Enumeration Date | 2020-02-08 | 
| Last Update Date | 2025-10-03 |