| NPI | 1740485549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA 89263) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 3555) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2025-09-11 |