| NPI | 1376061036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP241573) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 223687) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2024-10-03 |