| NPI | 1912272790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60802533) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005596) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 17629) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2021-12-06 |