| NPI | 1972642676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 45668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-65962-122) |
| 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: KS 74263) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2015-03-26 |