| NPI | 1073155313 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61686249) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 906207) | 
| Enumeration Date | 2019-10-08 | 
| Last Update Date | 2025-09-21 |