| NPI | 1679376156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010778) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0072762) |
| 163W00000X Registered Nurse (Licence: PA RN730597) | |
| 246RP1900X Technician, Pathology, Phlebotomy (Licence: PA PTC-7744) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP032378) | |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-08-05 |