| NPI | 1417701178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4047700) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1174848) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2025-11-04 |