| NPI | 1003397944 |
|---|---|
| Former Name | ANDREA ANNMARIE GOULBOURNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN2935672) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2935672) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2023-01-13 |