| NPI | 1811654361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4046490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1174358) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1174358) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2025-09-12 |