| NPI | 1992068084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 1073515) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 67498) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-10-11 |