| NPI | 1588072441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201508346NP-PP) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R1442) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201240333RN) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2015-11-02 |