| NPI | 1487354890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP028764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN762265) |
| 163W00000X Registered Nurse (Licence: WV 75971) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 117947) | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2024-09-19 |