| NPI | 1619152600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60684467) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60047476) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2020-07-31 |