| NPI | 1235794660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2358618) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2026-01-27 |