| NPI | 1255445532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 122553) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 5244) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-07-22 |