| NPI | 1336649649 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9331613)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9331613)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 149817)  | |
| Enumeration Date | 2018-02-14 | 
| Last Update Date | 2024-03-11 |