| NPI | 1285809673 |
|---|---|
| Former Name | NICOLE RENEE EDMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2016033090) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 01-52448) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL TRN15706) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME111414) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2022-07-21 |