| NPI | 1700087657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12443) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 000937) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-01-22 |