| NPI | 1740821453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201908534NP-PP) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR 201908534NP-PP) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201908534NP-PP) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2025-07-22 |