NPI | 1184254732 |
---|---|
Former Name | ASHLY FAY ROACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71009703A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28191649A) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2021-03-09 |