| NPI | 1912330549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IN 71004758A) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 17861) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71004758A) | |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2018-03-17 |