| NPI | 1538166541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002096) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3002096) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: KY 2096-S) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2022-02-03 |