| NPI | 1912005588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 214158) |
| Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MA 214158) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-05-28 |