| NPI | 1629708102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 32120) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN 238694) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024185183) | |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2023-11-09 |