| NPI | 1407102189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016000) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2024-05-09 |