| NPI | 1194777276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX PA01415) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA01415) | 
| Enumeration Date | 2006-05-16 | 
| Last Update Date | 2025-04-30 |