| NPI | 1598047045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202210894NP-PP) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 2224) |
| Enumeration Date | 2011-09-11 |
| Last Update Date | 2022-08-18 |