| NPI | 1649398694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 106663828900) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: AL 1-095255) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-01-07 |