NPI | 1235804261 |
---|---|
Former Name | AMANDA MICHELLE MALERICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71011446A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28211780A) |
Enumeration Date | 2021-08-11 |
Last Update Date | 2023-10-16 |