| NPI | 1194036814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10015443) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 202009577rn) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2023-09-22 |