| NPI | 1912374034 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201907881NP-PP) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201405166RN) | 
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-08-24 | 
| Last Update Date | 2023-09-15 |