| NPI | 1457337735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209005532) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 209005532) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2022-03-25 |