| NPI | 1639410228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 012412) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 550184) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2023-10-23 |