| NPI | 1518270412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 907562) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 1935) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2025-07-25 |