| NPI | 1821556598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA RN124479) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 267918) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2022-01-31 |