| NPI | 1215309489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP08722) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: LA RN071794) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2016-03-13 |