| NPI | 1245322155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2284745) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 113398) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 2284745) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-09-03 |