| 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 |