| NPI | 1962839985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 39414) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA sw128149) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2025-10-29 |