| NPI | 1386913119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 208767) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 208767) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2020-09-10 |