| NPI | 1649746876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP70067324) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60855842) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2025-12-05 |