| NPI | 1780773648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: CT 000942) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 000942) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-09-28 |