| NPI | 1659721132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 11536-33) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WI 184402) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 184402) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2021-11-15 |