NPI | 1750924338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2360906) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 780977-01) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403892) | |
163W00000X Registered Nurse (Licence: MA RN2360906) | |
Enumeration Date | 2019-10-25 |
Last Update Date | 2025-10-07 |