| NPI | 1972835759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 201406916RN) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2015-01-12 |