| NPI | 1811239445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000735) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 12049) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2019-01-07 |