| NPI | 1407651359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4035625) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1113808) |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-03-17 |