| NPI | 1508372392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5010120) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010120) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC WATK-QPVF31) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 50101020) | |
| Enumeration Date | 2017-12-16 |
| Last Update Date | 2023-12-06 |