| NPI | 1083653257 |
|---|---|
| Former Name | DEBRA E BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R778758) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MS R778758) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-06-08 |