| NPI | 1629445036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA 071409) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPN071409) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2021-03-07 |