| NPI | 1194725499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 105016) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6404) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP2124372) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP2124372) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-11-19 |