| NPI | 1710014758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 112138) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 3926) |
| 101YP2500X Counselor, Professional (Licence: NE 1947) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-03-29 |