| NPI | 1942555065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024194577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN297807L) |
| 163W00000X Registered Nurse (Licence: NC 342891) | |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2025-09-10 |