| NPI | 1386316032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11036746) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2024-12-10 |