| NPI | 1760517601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NE 57543) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 7525) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2025-09-11 |