| NPI | 1427722917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2288835) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2118) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MA 6873) | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2024-01-25 |