| NPI | 1699142778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704266843) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704266843) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2025-11-14 |