| NPI | 1720835879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10058512) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201910819RN) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2026-03-26 |