| NPI | 1710190715 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 200090) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209012728) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5008825) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5378313062) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP9708) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F4025561) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 7401) | |
| Enumeration Date | 2007-05-07 | 
| Last Update Date | 2022-12-15 |