NPI | 1174715957 |
---|---|
Former Name | CYLLENE HOLMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2009011171) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 281148) | |
Enumeration Date | 2007-08-15 |
Last Update Date | 2024-08-30 |