| NPI | 1164665253 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 001186)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 001831)  | 
| Enumeration Date | 2009-04-20 | 
| Last Update Date | 2009-04-20 |