NPI | 1235784786 |
---|---|
Former Name | WESLEY ANN CRECELIUS RIVERA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: AK 127542) |
Enumeration Date | 2019-08-01 |
Last Update Date | 2019-08-01 |