| NPI | 1336617448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2381440) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 7620) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2025-03-14 |