| NPI | 1346866811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61663934)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2020-06-22 | 
| Last Update Date | 2025-02-24 |