| NPI | 1518142116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 058266) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MO 058266) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9654) | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2023-01-18 |