| NPI | 1487810537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71009037A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001984A) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2021-02-08 |