| NPI | 1780025502 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201341398RN) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2013-07-09 | 
| Last Update Date | 2013-07-09 |