| NPI | 1780396572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3018928) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1145024) |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2024-12-16 |