| NPI | 1881952430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Adolescent (Licence: PA RN122973L) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |