| NPI | 1710020557 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN282298)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5260)  | 
| Enumeration Date | 2007-02-14 | 
| Last Update Date | 2023-04-24 |