NPI | 1265528756 |
---|---|
Former Name | KATHLEEN ROSEMARIE DEMARAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MI 4704110454) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2007-07-08 |