| NPI | 1851423776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1017) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 093006739N6) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |