| NPI | 1861775264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 20033) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4815) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5008661) | |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2022-09-20 |