| NPI | 1275254286 |
|---|---|
| Former Name | MARY THERESE O PUENTES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95021158) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2023-06-16 |