| NPI | 1568663961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024179861) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: VA 0001189020) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2022-12-14 |