| NPI | 1811103039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 739) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NH 186) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-03-17 |