| NPI | 1003598822 |
|---|---|
| Former Name | JENNIFER MALTBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-217530) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |