| NPI | 1164460259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: OR 201401150RN) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA RN 436250) |
| 101YM0800X Counselor Mental Health (Licence: CA CNS 1914) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-07-21 |