| NPI | 1417575325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1076811) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 66164) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2023-08-29 |