| NPI | 1598763989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ RN099009) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ RN099009) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2007-07-08 |