| NPI | 1295972768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP4352) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3970) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2019-03-27 |