| NPI | 1205173911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5006145) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 22 545597) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC mb2889799) | |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2019-04-01 |