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