| NPI | 1609275627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN221778) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA RN221778) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2022-03-02 |