| NPI | 1760135602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1157176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 838258) |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2025-11-03 |