| NPI | 1760003719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016839) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184964) | |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2023-02-13 |