| NPI | 1174795553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704314454) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801087284) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2026-05-20 |