NPI | 1770861007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4704) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CT 03277675) |
163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CT 092976) | |
Enumeration Date | 2011-08-03 |
Last Update Date | 2022-12-09 |