| NPI | 1205550746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 114484) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018378) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 114484) | |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2025-11-10 |