| NPI | 1144881475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201907600NP-PP) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OR 200540436RN) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2020-01-29 |