| NPI | 1215281183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2351116) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA MA9706) |
| 101YM0800X Counselor, Mental Health (Licence: ME XL3913) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2025-08-25 |