| NPI | 1982301784 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11024314) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61671872) | 
| 163W00000X Registered Nurse (Licence: FL RN9435123) | |
| Enumeration Date | 2023-02-13 | 
| Last Update Date | 2025-09-03 |