| NPI | 1245955921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 11765778-4405) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2024-03-04 |