| NPI | 1982832705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024186851) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN.128419-IV) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-04-27 |