| NPI | 1164777868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11037405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN 9332773) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2025-04-28 |