| NPI | 1689236218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019024648)  | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202213255NP-PP)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-84429-031)  | |
| Enumeration Date | 2019-07-03 | 
| Last Update Date | 2025-06-16 |