| NPI | 1972955912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI APRN01397) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11342) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2022-01-13 |