| NPI | 1609240852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024180498) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001233254) |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2026-06-12 |