| NPI | 1730646738 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 201406957RN) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2019-02-26 | 
| Last Update Date | 2019-05-31 |