| NPI | 1669719035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP135264) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 220188) |
| Enumeration Date | 2013-01-05 |
| Last Update Date | 2017-12-04 |