| NPI | 1649630930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202111133NP-PP) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHPC-00723) | |
| 163W00000X Registered Nurse (Licence: OR 201041290RN) | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2021-10-06 |