NPI | 1851864805 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4012489) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1158238) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2024-08-07 |