| NPI | 1104472786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201907159NP-PP) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201708299RN) |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2020-02-17 |