| NPI | 1174749782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2347772) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME cc2493) |
| 163W00000X Registered Nurse (Licence: MA 2347772) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-11-21 |