| NPI | 1154969079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61199567) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60683077) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2022-03-04 |