| NPI | 1821504002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95028134) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 103914) |
| Enumeration Date | 2017-12-24 |
| Last Update Date | 2023-11-23 |