| NPI | 1417413998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.012213) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2023-08-08 |