| NPI | 1801509633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1100828) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 71201) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0100321) | |
| Enumeration Date | 2022-12-26 |
| Last Update Date | 2024-10-18 |