| NPI | 1982293551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4042419) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1170383) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1170383) | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2025-06-18 |