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 |