| NPI | 1659357994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/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 |