| NPI | 1639513153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209021943) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180008580) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071008694) | |
| 163W00000X Registered Nurse (Licence: IL 041417556) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2021-09-09 |