| NPI | 1205180742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP7312) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN187955) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2014-09-15 |