| NPI | 1841708039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11048539) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-121779) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2026-07-24 |