| NPI | 1316246655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201392025NP-PP) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6643812-4408) | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2013-11-19 |