| NPI | 1356614465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163W00000X Registered Nurse (Licence: NC 204626) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NC 204626) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2022-06-22 |