| NPI | 1245617133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016319) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 157326) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2022-06-07 |