| NPI | 1366919078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1096881) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 955285) | 
| Enumeration Date | 2018-10-31 | 
| Last Update Date | 2025-04-14 |