| NPI | 1750611109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61330133) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61330133) | 
| Enumeration Date | 2010-01-07 | 
| Last Update Date | 2025-08-20 |