| NPI | 1386743060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 1589057) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 63565030) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 1908033) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-04-27 |