NPI | 1255565792 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0015000875) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024181898) |
Enumeration Date | 2009-05-12 |
Last Update Date | 2022-06-06 |