| NPI | 1861036832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 46161) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 35882) |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2020-07-03 |