| NPI | 1447312103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: OR 200350003NP) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR 200350003NP) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2016-10-25 |