NPI | 1770394645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1002503) |
Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX 2024096348) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: TX 2024096348) | |
Enumeration Date | 2025-01-18 |
Last Update Date | 2025-09-04 |