| NPI | 1629617774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11009388) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9423089) |
| 163W00000X Registered Nurse (Licence: IL 041431448) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209022748) | |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2023-06-12 |