NPI | 1053078329 |
---|---|
Former Name | CHANTAL HUDAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019528) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 2020717) |
Enumeration Date | 2021-11-22 |
Last Update Date | 2022-06-10 |