| NPI | 1568449619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 194725-4405) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: UT 1947254405) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2023-03-07 |