| NPI | 1508129834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 323493-8900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 323493-3102) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 323493-4405) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2017-04-13 |