| NPI | 1619372364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-266525) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT APRN-266525) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2026-01-29 |