| NPI | 1417621541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277003835) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036083810) |
| 261Q00000X Clinic/Center (Licence: IL 036083810) | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2025-04-24 |