| NPI | 1518167949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R836775) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP06825) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R836775) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2023-03-02 |