| NPI | 1790059103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5009850) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC co10514) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2010012064) | |
| 163WC1500X Registered Nurse, Community Health (Licence: MO 2010004568) | |
| 163WC1500X Registered Nurse, Community Health (Licence: NC 293967) | |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2022-07-21 |