| NPI | 1558879114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110975) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME124792) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2021-05-20 |