| NPI | 1720502529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2373423) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 12235) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2024-12-09 |