| NPI | 1164776563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3011435) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 00220316) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5019969) | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2024-06-04 |