NPI | 1184406142 |
---|---|
Former Name | SCHYLER BLAKE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 34861) |
Enumeration Date | 2023-10-16 |
Last Update Date | 2023-11-30 |