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 |