| NPI | 1558679050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5004871) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 1431) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5004871) | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2022-09-27 |