NPI | 1265069504 |
---|---|
Other Name | JACQUETTA GARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024180091) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: VA 0001213031) |
Enumeration Date | 2020-03-25 |
Last Update Date | 2024-10-29 |