NPI | 1376061036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/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 |