| NPI | 1528959806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209033141) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041428393) |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-11-18 |