| NPI | 1881343713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 867767) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1144604) | |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2024-07-12 |