| NPI | 1720099492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024075685) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710001227) |
| 163W00000X Registered Nurse (Licence: VA 0001075685) | |
| 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: VA 0015000635) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-03-07 |