| NPI | 1548418114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 18154.0972) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-76831-101) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2015-09-29 |