| NPI | 1497772982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 1891033) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 3278125) |
| 163W00000X Registered Nurse (Licence: WI 124305030) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-07-21 |