| NPI | 1932497922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209008803) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 209008803) |
| 101YM0800X Counselor, Mental Health (Licence: IL 209008803) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2012-05-17 |