| NPI | 1487345088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: VA 0001255949) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0732007216) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0733006490) | |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |