| NPI | 1023723038 |
|---|---|
| Former Name | MALLORY AMBER LAFFOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 95306112) |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-01-16 |