| NPI | 1912716200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2279515) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2279515) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI APRN04545) | |
| 163W00000X Registered Nurse (Licence: RI RN79950) | |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-10-09 |