| NPI | 1568515195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 19205) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163W00000X Registered Nurse (Licence: CA 547387) | |
| 363L00000X Nurse Practitioner (Licence: CA 19205) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-12-04 |