| NPI | 1649771668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704324919) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704324919) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV 840880) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 022502) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019032) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1033221) | |
| Enumeration Date | 2018-02-25 |
| Last Update Date | 2022-04-18 |