| NPI | 1427803527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11032423) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 11032423) |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2025-08-20 |