| NPI | 1063021087 |
|---|---|
| Former Name | LESLIE RENEE TRIVETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 28014) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2024-04-06 |