| NPI | 1588648695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 13-32105-041) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 74118) |
| 103T00000X Psychologist (Licence: KS 1394) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2023-03-07 |