| NPI | 1942768866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3013876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 25505) |
| Enumeration Date | 2019-03-10 |
| Last Update Date | 2025-09-23 |