| NPI | 1457844573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-139047) |
| Additional Taxonomies | 2084P0805X (Licence: AL 1-139047) |
| 251S00000X Community/Behavioral Health (Licence: AL 1-139047) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-139047) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2025-05-21 |