| NPI | 1104697564 |
|---|---|
| Former Name | COLETTE RAE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: MN 2185949) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-12 |