| NPI | 1982790515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IN 70000155A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35000181A) |
| 363L00000X Nurse Practitioner (Licence: IN 70000155A) | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IN 70000155B) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-11-12 |