| NPI | 1972966646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OR 201240694RN) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OR 201240694RN) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2019-06-05 |