| NPI | 1649495722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003571) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 000600) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2014-07-22 |