| NPI | 1023895687 |
|---|---|
| Former Name | BRENDA LEE VINSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: IL 041.400040) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-08 |