| NPI | 1649370503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MS R873301) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MS C6737) |
| 106H00000X Marriage & Family Therapist (Licence: MS C6737) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-01-27 |