NPI | 1245679463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR TBD) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: OR 202009213RN) |
225700000X Massage Therapist (Licence: OR 19165) | |
Enumeration Date | 2013-06-20 |
Last Update Date | 2023-07-13 |