| NPI | 1215713631 |
|---|---|
| Former Name | MACY MICHELLE GOLLADAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209030396) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN286821) |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2024-10-09 |