| NPI | 1265200158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11037782) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL 9407940) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2025-05-02 |