| NPI | 1194464842 |
|---|---|
| Former Name | SARAH RENAE FREDLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CO RN.0200805) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |