| NPI | 1710189360 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200950074NP)  | 
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: OR 200740981RN)  | 
| Enumeration Date | 2007-06-05 | 
| Last Update Date | 2014-01-28 |