| NPI | 1467522276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 1238) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 5534) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2019-05-20 |