| NPI | 1356564371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA Z039867) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IA i15078) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA 039867) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2017-03-23 |