| NPI | 1700490349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5013308) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024180592) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000715) | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2025-09-17 |