| NPI | 1467995613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 21689) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1217218) |
| 163W00000X Registered Nurse (Licence: TN 180500) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2026-01-28 |