| NPI | 1487788725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: LA 250415) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA mbe36399877k) |
| 175T00000X Peer Specialist (Licence: LA OBHPSS1194) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2025-01-16 |