| NPI | 1861260101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1140790) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 1140790) |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2024-08-27 |