| NPI | 1194120089 |
|---|---|
| Former Name | SUSAN P MUMFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0000179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000793) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2022-02-14 |