| NPI | 1205144953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704324517) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401011711) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2024-08-20 |