| NPI | 1710667829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11027505) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN1027505) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-10-17 |