| NPI | 1982053674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP142355) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 57866) |
| 163W00000X Registered Nurse (Licence: TX 926242) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2019-07-20 |