| NPI | 1710504253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 4903959-4405) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: UT 4903959-3102) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-12-11 |