NPI | 1003362617 |
---|---|
Former Name | JULIANA MCCLINTOCK AYRES DOHERTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201802512NP-PP) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 2018004137) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2024-03-05 |