| NPI | 1487009718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704255268) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 4704255268) |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2016-04-25 |