| NPI | 1649741562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 2025087817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 921244) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2026-06-17 |