| NPI | 1730626524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 8958) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-16408) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2022-02-28 |