| NPI | 1790115418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DC RN1013158) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: DC RN1013158) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2021-07-01 |