| NPI | 1326755653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11014280) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 115314) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G178922) | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-08-10 |