| NPI | 1205954161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MA RN101705) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 101705) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2016-09-08 |