| NPI | 1821588476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3012606) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012606) |
| 363L00000X Nurse Practitioner (Licence: OH RN.390834) | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2023-03-28 |