| NPI | 1659706752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209010691) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180006039) |
| Enumeration Date | 2013-09-08 |
| Last Update Date | 2013-09-10 |