| NPI | 1720791106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11024528) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 11024528) |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-04-06 |