| NPI | 1619196714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1000559) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NY 583418) |
| 163WC1500X Registered Nurse, Community Health (Licence: NY 583418) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 589994) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2024-05-30 |