| NPI | 1962997031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9361328) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9361328) | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-02-16 |