| NPI | 1124290952 |
|---|---|
| Former Name | KATHERINE BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5852) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 156913-030) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2014-12-02 |