| NPI | 1164050522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 299888) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1144) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical (Licence: NH 2449) | |
| 163W00000X Registered Nurse (Licence: NH 087264-21) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-05-27 |