| NPI | 1689000937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.61243362) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2022-11-07 |