| NPI | 1962132035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184707) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001269939) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0024184707) | |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2024-12-16 |