| NPI | 1801174008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11017864) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2002032344) |
| 101YM0800X Counselor, Mental Health (Licence: FL 17148) | |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2022-02-03 |