| NPI | 1679145353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL 11014142) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 11014142) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-21 |