| NPI | 1376736363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9292609) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 8287) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2010-12-28 |