| NPI | 1053931147 |
|---|---|
| Former Name | BAILEY NICOLE WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA R-11946) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 4351052042) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-08-29 |