| NPI | 1467975730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2350434) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2024-09-05 |