| NPI | 1689405763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11035471) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL PMH08240102) | 
| Enumeration Date | 2024-08-12 | 
| Last Update Date | 2024-09-23 |