| NPI | 1174376610 |
|---|---|
| Former Name | BETSY A PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: WI 15236) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-06-05 |