| NPI | 1528461340 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 256972) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 256972) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 256972) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-11-28 |