| NPI | 1245874981 |
|---|---|
| Former Name | KIM MICHELLE STUBBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 904293) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R883514) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS R883514) | |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2021-04-14 |