| NPI | 1043737539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: OR 200170086CNS) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 081034855N6) | 
| Enumeration Date | 2017-08-24 | 
| Last Update Date | 2022-07-21 |