| NPI | 1255333894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G132903) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 00717) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2026-07-10 |