| NPI | 1225613896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 8329) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8329) |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2025-01-30 |