| NPI | 1790010395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 10011) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2790) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CO 184090) | |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2016-07-01 |