| NPI | 1629321211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN267349) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 664254) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2022-12-29 |