| NPI | 1679861447 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 089006518RN) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2011-07-14 | 
| Last Update Date | 2011-07-14 |