| NPI | 1619288446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: WY 27240.1075) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 27240.1075) |
| Enumeration Date | 2010-06-26 |
| Last Update Date | 2016-07-11 |