NPI | 1306261615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209021646) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2014-02-23 |
Last Update Date | 2020-09-02 |