| NPI | 1962686519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP019495) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00872400) |
| 163W00000X Registered Nurse (Licence: PA RN269163L) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404151) | |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2023-12-07 |