NPI | 1073045423 |
---|---|
Former Name | PAMELA HANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 145635) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WI 145635) |
Enumeration Date | 2017-04-03 |
Last Update Date | 2023-09-11 |