| NPI | 1568773810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.025372) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 6370) |
| 101YP2500X Counselor, Professional (Licence: IL 180003613) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-09-14 |