| NPI | 1164939021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 14662) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 008568) |
| 163W00000X Registered Nurse (Licence: CT 157753) | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2025-04-21 |