| NPI | 1841268919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NH 865) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NH 0336082305) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |