NPI | 1346536117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9251709) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL ARNP9251709) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2020-11-27 |