| NPI | 1295890259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2432-057) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 104606-030) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 1526-033) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |