| NPI | 1265530745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024166629) | 
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: VA 0015000625) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2008-01-16 |