| NPI | 1174188841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2390392) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical | 
| 163W00000X Registered Nurse (Licence: MA 2390392) | |
| Enumeration Date | 2019-05-07 | 
| Last Update Date | 2025-07-18 |