| NPI | 1255336145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 183538 PC) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA 183538) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN183538) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2024-09-10 |