| NPI | 1376275313 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11040526) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: FL CBHCM104470) | 
| Enumeration Date | 2022-06-28 | 
| Last Update Date | 2025-07-13 |