| NPI | 1295400422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID CNP68968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 61367) |
| 363L00000X Nurse Practitioner (Licence: OR 202108825np) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 61367) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 202108825np) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 61367) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202108825np) | |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2025-04-08 |