| NPI | 1467768499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN APN15451) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163W00000X Registered Nurse (Licence: TN 172980) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2016-03-07 |