| NPI | 1114470952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201705849NP-PP) |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse (Licence: OR 201507180RN) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2022-10-12 |