NPI | 1275628760 |
---|---|
Former Name | MARY JEANNE VELLELA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP3135372) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2012-01-06 |