| NPI | 1922753045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11017972) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL APRN11017972) | 
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL 11017972) | |
| Enumeration Date | 2022-02-17 | 
| Last Update Date | 2025-06-17 |