| NPI | 1700065208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD R025102) |
| Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: SD R025102) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |