| NPI | 1740621861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201508855NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 643270) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401643-1) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2016-03-01 |