| NPI | 1417794132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 120335) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 373301) |
| 163W00000X Registered Nurse (Licence: WV 82730) | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-09-01 |