| NPI | 1730170408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 074886) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NC 074886) |
| 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MD 2005001113) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NC 074886) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-07-08 |