| NPI | 1285195636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3013299) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25749) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA APRN0000025749) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-11-20 |