| NPI | 1942555065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5023582) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 342891) |
| 163W00000X Registered Nurse (Licence: PA RN297807L) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024194577) | |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2025-12-21 |