| NPI | 1285736496 |
|---|---|
| Former Name | MARY JOSEPHINE RADECKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 266603) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NY 0287960-01) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |