| NPI | 1407106446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12432) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 007898) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2024-01-13 |