NPI | 1538184742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WY 8459) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY 259) |
163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: MI 101062) | |
Enumeration Date | 2006-07-12 |
Last Update Date | 2011-10-05 |