| NPI | 1780464495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11033693) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL 9501507) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-11-18 |