| NPI | 1811474596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2270119) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-09-18 |