| NPI | 1851406573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 2011021217) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 643307) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-12-01 |