| NPI | 1679308423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4026229) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1137394) |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2025-12-12 |