| NPI | 1952714537 |
|---|---|
| Former Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 303228) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 865004) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA RN2273461) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2024-03-14 |