| NPI | 1861498586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003308) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000558) |
| 1041C0700X Social Worker, Clinical (Licence: CT 004973) | |
| 163W00000X Registered Nurse (Licence: CT 072669) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2011-02-04 |