| NPI | 1760035836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA Rn264691) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 264691) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-02-14 |