| NPI | 1114707445 |
|---|---|
| Former Name | MELISSA WALRAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 2023129826) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-05 |