| NPI | 1053645770 |
|---|---|
| Former Name | LISA MARIE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 6593775-3102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 130269) |
| 163W00000X Registered Nurse (Licence: UT 6593775-3102) | |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2020-08-20 |