| NPI | 1649471285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2269982) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6290) |
| 163W00000X Registered Nurse (Licence: MA RN2269982) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-11-16 |