| NPI | 1407969793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS015265) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: PA PS015265) |
| 163W00000X Registered Nurse (Licence: PA RN219172L) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: PA RN219172L) | |
| 363L00000X Nurse Practitioner (Licence: PA SP007233) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP007233) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2025-09-11 |