| NPI | 1457379067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 26971) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 26971) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-06-16 |