| NPI | 1174218440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL APRN11024731) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163W00000X Registered Nurse (Licence: FL RN9492859) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-12-12 |