| NPI | 1720162332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 1045) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: AK 491) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AK 4018) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-11-14 |