| NPI | 1508325549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12179) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 10452) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-08-09 |