| NPI | 1205287851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11034817) | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL APRN11034817) | |
| Enumeration Date | 2016-06-24 | 
| Last Update Date | 2025-07-22 |