| NPI | 1538484035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2306687) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7251) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2306687) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2023-01-24 |