| NPI | 1740840974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AR L46136) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-06-19 |