| NPI | 1619967569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 2005000649) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: ME CNP171177) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2025-02-04 |