| NPI | 1740980234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL APRN11024878) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11024878) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2025-01-29 |