| NPI | 1871132084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11028901) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2024-04-09 |