NPI | 1245059997 |
---|---|
Former Name | KIZZY CHAUNTA RAGLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KY 1152844) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: KY 1152844) |
Enumeration Date | 2024-10-09 |
Last Update Date | 2024-10-09 |