| NPI | 1790599074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10044968) |
| Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: OR 200842532RN) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 200842532RN) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OR 200842532RN) | |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-07-15 |