| NPI | 1316792666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL RN9378391) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN11032414) |
| Enumeration Date | 2024-04-20 |
| Last Update Date | 2026-05-20 |