| NPI | 1790002772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NM R46689) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R46689) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: NM R46689) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2014-10-17 |