| NPI | 1588979314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 62736)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN62736-NP-C)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183957)  | |
| Enumeration Date | 2010-08-17 | 
| Last Update Date | 2024-10-16 |