NPI | 1053038521 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 202214429RN) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202214429RN) |
225700000X Massage Therapist (Licence: OR 14111) | |
Enumeration Date | 2022-10-25 |
Last Update Date | 2024-12-01 |