| NPI | 1366037160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3015884) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2025-08-21 |