| NPI | 1972804474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 902088) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 1056) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 902088) | |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2022-10-14 |