| NPI | 1972590800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 000642) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002570) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2025-09-11 |