NPI | 1205289469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11005752) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95024404) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL RN9376191) | |
Enumeration Date | 2016-07-22 |
Last Update Date | 2020-01-14 |