NPI | 1467053553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 258930) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ RN210167) |
Enumeration Date | 2020-11-04 |
Last Update Date | 2022-09-14 |