| NPI | 1174232813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN190985) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC008171) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2024-12-18 |