| NPI | 1578107637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71011078A) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 657425) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1020932) | |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2021-05-28 |