NPI | 1124683008 |
---|---|
Former Name | JOANNA KRISTINE CLEMENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95053961) |
Enumeration Date | 2019-05-06 |
Last Update Date | 2019-05-06 |