NPI | 1972590800 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002570) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 000642) |
Enumeration Date | 2005-10-05 |
Last Update Date | 2007-07-08 |