| NPI | 1639375678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WY 1580) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 256189) |
| 163W00000X Registered Nurse (Licence: AZ 231322) | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: WY 388521580) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 231322) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN256189) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2021-01-05 |