| NPI | 1558573154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MI 110675) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801017113) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301007629) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 110675) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2025-09-11 |