| NPI | 1316712763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2321959) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MA RN2321959) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2024-07-17 |