| NPI | 1588868921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM CNP-02382) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ RN030428) |
| 363L00000X Nurse Practitioner (Licence: AZ RN030428) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2014-07-31 |