| NPI | 1245613421 |
|---|---|
| Former Name | KATHLEEN MARY IVIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: NV RN69887) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |