| NPI | 1861005548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11037263) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2025-01-17 |