| NPI | 1952736738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7986) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 003280) |
| 103TC1900X Psychologist, Counseling (Licence: CT 003280) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CT 003280) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2019-07-03 |