| NPI | 1104802099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 70027516) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 565202) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2025-08-01 |