| NPI | 1265164008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN311096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2307292) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2307292) | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MA RN2307292) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2307292) | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-08-07 |