| NPI | 1295873917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 000027989N6) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 00027989C) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2010-06-03 |