| NPI | 1558171637 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 2025038196) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 805188) | 
| Enumeration Date | 2025-01-10 | 
| Last Update Date | 2025-09-05 |