NPI | 1164555488 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA RN211395) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY20943) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2016-03-30 |