| NPI | 1801270236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2292267) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2292267) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2022-02-08 |