| NPI | 1184818817 |
|---|---|
| Former Name | TWANA LYN MCVICKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9491251) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: TX 602109) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2019-10-07 |