| NPI | 1225897374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024192184) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 00031307366) |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2025-04-21 |