| NPI | 1285266460 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ 052057) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 6867260) | 
| Enumeration Date | 2020-02-06 | 
| Last Update Date | 2020-02-06 |