| NPI | 1306070701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11016895) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN074267) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2021-12-20 |