| NPI | 1902031099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R903178) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-140387) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2022-01-14 |