| NPI | 1356631022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 17710) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC R 54531) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2012-05-18 |