| NPI | 1598255820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: UT 8781234-4405) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |