NPI | 1639291057 |
---|---|
Former Name | MARYKAY HJORTEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 082010334N6) |
Enumeration Date | 2007-04-05 |
Last Update Date | 2014-03-31 |