NPI | 1619265006 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11011837) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2011-07-19 |
Last Update Date | 2021-04-22 |