| NPI | 1417428095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11000482) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 11000482) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11000482) | |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2025-12-17 |