NPI | 1801440763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11004531) |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL RN9510809) | |
Enumeration Date | 2019-07-30 |
Last Update Date | 2020-02-13 |