| NPI | 1386134021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11042758) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL ALC04534) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2025-11-18 |