| NPI | 1235436171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2312255) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 118396) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA RN2312255) | |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2018-10-04 |