| NPI | 1659784528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209029664) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041406961) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041406961) | |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2024-05-22 |