| NPI | 1902482300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IA 131852) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 21037) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-06-19 |