NPI | 1154903680 |
---|---|
Former Name | LAKISHA MONIKE STEVENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405244) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 30055) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 904795) | |
Enumeration Date | 2021-04-23 |
Last Update Date | 2024-08-29 |