| NPI | 1255155495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2273492) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MA RN2273492) |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2025-10-16 |