| NPI | 1215136841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2320119) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1026911) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2019-08-08 |