| NPI | 1972191781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 10217) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403588) | |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2022-03-23 |