| NPI | 1790113413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60994940) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA 743080021) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2019-10-10 |