| NPI | 1295335503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 39700) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DE Q3-0000221) |
| 163W00000X Registered Nurse (Licence: DE L1-0074430) | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2025-11-17 |