| NPI | 1568412484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC000599) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: PA SP007694) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP007694) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |