| NPI | 1194987065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-044311) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163W00000X Registered Nurse (Licence: TN RN0000214091) | |
| 363L00000X Nurse Practitioner (Licence: AL 1-044311) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 21210) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2020-10-05 |