| NPI | 1972213221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024191207) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 266144) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 34902) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC006942) | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2025-05-08 |