| NPI | 1457749731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 8491) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8491) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2025-07-15 |