| NPI | 1568143253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11028223) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 77393) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1147111) | |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-04-10 |