| NPI | 1164199774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9449) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9886) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL TPAN2506) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1166924) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0137710TELE) | |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2025-12-08 |