| NPI | 1992939052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704170742) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MI 4704170742) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2021-04-12 |