| NPI | 1215922901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: VT 101.0134660) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005936) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VT 101.0134660) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 005936) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-002904) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005936) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2021-09-14 |