| NPI | 1164983243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9944) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 7581491) |
| 163W00000X Registered Nurse (Licence: CT 179370) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403675) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2021-09-13 |