| NPI | 1376674010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 200401185) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 6455) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-05-22 |