| NPI | 1376204685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184757) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001135026) |
| Enumeration Date | 2022-01-08 |
| Last Update Date | 2024-12-04 |