| NPI | 1386700441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11039) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ lisac10114) |
| 101Y00000X Counselor (Licence: AZ lpc1994) | |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2018-06-28 |