| NPI | 1902415953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 9208) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CT 109095) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2023-02-23 |