| NPI | 1083125017 |
|---|---|
| Former Name | ELIZABETH THERESE KREAGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA2844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010553) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6802089761) | |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2024-05-14 |