| NPI | 1376825158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95020534) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS26202) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2022-07-21 |