| NPI | 1841600608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.024190) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2021-10-13 |