| NPI | 1225669724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61078831) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 154866) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-08-20 |