| NPI | 1255031456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11026331) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1218433) |
| 363L00000X Nurse Practitioner (Licence: FL F02230652) | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2026-03-12 |