| NPI | 1730146663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704142322) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801063331) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-08-01 |