| NPI | 1639721269 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 29365)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 173999)  | 
| 363L00000X Nurse Practitioner (Licence: NC 5012406)  | |
| 363L00000X Nurse Practitioner (Licence: SC 29365)  | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012406)  | |
| Enumeration Date | 2019-07-13 | 
| Last Update Date | 2024-09-26 |