| NPI | 1720383177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023043834) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA RN 225666) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2024-01-04 |