| NPI | 1407904030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP010760) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PA RN560645) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NJ 26NJ00137900) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-09-22 |