| NPI | 1508564022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2390809) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163W00000X Registered Nurse (Licence: MA RN2390809) | |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2026-04-27 |