NPI | 1497282008 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2017008864) |
Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: MO 2016032658) |
Enumeration Date | 2017-05-12 |
Last Update Date | 2024-05-31 |