| NPI | 1265501605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 066468-23) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 392) | 
| Enumeration Date | 2006-11-07 | 
| Last Update Date | 2025-01-22 |