| NPI | 1710473517 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9256994) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9256994) | 
| Enumeration Date | 2018-07-03 | 
| Last Update Date | 2025-05-20 |