| NPI | 1720557598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9407152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9407152) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406599) | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2025-05-27 |