| NPI | 1174966964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI 00011) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.119474) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 5813) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.005813) | |
| 163W00000X Registered Nurse (Licence: MA RN2284858) | |
| 163W00000X Registered Nurse (Licence: RI 52001) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2019-11-15 |