| NPI | 1790335214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN197629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 197629) |
| 363L00000X Nurse Practitioner (Licence: MA 197629) | |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2025-05-08 |