| NPI | 1194886317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 654342) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL sw5736) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-01-21 |