| NPI | 1366721664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 13009) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 002078) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-05-21 |