| NPI | 1053020867 | 
|---|---|
| Professional Name | SAMARA ALEXIS GLAVIN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61403677)  | 
| Enumeration Date | 2022-11-21 | 
| Last Update Date | 2023-02-21 |