| NPI | 1669228896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN10009649) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0050720) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010670) | |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2025-08-21 |