NPI | 1053849851 |
---|---|
Former Name | MARNIE BASTA COLLETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-125902) |
Enumeration Date | 2017-05-24 |
Last Update Date | 2017-05-24 |