| NPI | 1568226652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6551115-44-5) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 6551115-4405) |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2025-11-15 |