NPI | 1659357994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ AP3964) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: AZ LCSW2180) |
363LF0000X Nurse Practitioner Family (Licence: AZ AP0842) | |
Enumeration Date | 2005-12-19 |
Last Update Date | 2017-04-13 |