| NPI | 1639786650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.029378) |
| Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: IL 209.029378) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2025-03-20 |