| NPI | 1871117929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9510243) |
| 163W00000X Registered Nurse (Licence: OH 431561) | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-28 |