| NPI | 1972022549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01479) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI PA01479) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI PA01479) | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2024-07-12 |