| NPI | 1639775281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 16340-33) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: IL 041.273400) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209024477) | |
| 163W00000X Registered Nurse (Licence: WI 121496-30) | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2026-01-07 |