| NPI | 1215190657 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 9824823-8900)  | 
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200850067NP)  | |
| Enumeration Date | 2008-07-07 | 
| Last Update Date | 2022-07-21 |