| NPI | 1902204217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11040477) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9522588) |
| 164W00000X Licensed Practical Nurse (Licence: FL PN 5157469) | |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2025-09-29 |